Under minimal supervision the Case Manager-RN, Utilization Review, reviews and screens for the appropriateness of services, the utilization of hospital resources and quality of patient care rendered at Henry Ford Allegiance Health. Combines clinical, business and regulatory knowledge and skill to reduce significant financial risk and exposure caused by concurrent and retrospective denial of payments for services provided. Through continuous assessments, problem identification and education, facilitates the quality of health care delivery in the most cost effective and efficient manner.
EDUCATION/EXPERIENCE REQUIRED:
Current enrollment in a Bachelor's in Nursing (BSN) program or active pursuit of BSN degree with the completion of six (6) semester hours during the first year of employment. Must remain enrolled in BSN program and complete six (6) semester hours annually until degree is obtained
Recent clinical experience with specific patient population
Knowledge of care of neonate, pediatric, adolescent, adult, and geriatric patients
Ability to function successfully in an extremely challenging environment
Demonstrates leadership ability, communications, and interpersonal skills necessary to interact effectively with physicians, management, staff, external agencies/customers and patients/families
Must possess analytical, data management and computer skills
Must demonstrate initiative and willingness to learn
Must be self-directed, flexible, committed to teamwork
CERTIFICATIONS/LICENSURES REQUIRED:
Current Michigan Nursing license
PREFERRED QUALIFICATIONS:
Bachelor's Degree in Nursing (BSN)
Case Management certification
Utilization management and discharge planning experience for the acute care or post- acute care setting
Overview Under the leadership of President and CEO Wright L. Lassiter, III, Henry Ford Health System is a $6 billion integrated health system comprised of six hospitals, a health plan, and 250+ sites including medical centers, walk-in and urgent care clinics, pharmacy, eye care facilities and other healthcare retail. Established in 1915 by auto industry pioneer Henry Ford, the health system now has 32,000 employees and remains home to the 1,900-member Henry Ford Medical Group, one of the nation's oldest physician groups. An additional 2,200 physicians are also affiliated with the health system through the Henry Ford Physician Network. Henry Ford is also one of the region's major academic medical centers, receiving between $90-$100 million in annual research funding and remaining Michigan's fourth largest NIH-funded institution. Also an active participant in medical education and training, the health system has trained nearly 40% of physicians currently practicing in the state and also provides education and training for other health professionals including nurses, pharmacists, radiology and respiratory technicians. visitHenryFord.com. Benefits Whether it's offering a new medical option, helping you make healthier lifestyle choices or making the employee enrollment selection experience easier, it's all about choice. Henry Ford Health System has a new approach for its employee benefits program - My Choice Rewards. My Choice Rewards is a program as diverse as the people it serves. There are dozens of options for all of our employees including compensation, benefits, work/life balance and learning - options that enhance your career and add value to your personal life. As an employee you are provided access to Retirement Programs, an Employee Assistance Program (Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness, and a whole host of other benefits and services. Employee's classified as contingent status are not eligible for benefits. Equal Employment Opportunity/Affirmative Action Employer Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health System is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height, weight, marital status, family status, gender identity, sexual orientation, and genetic information, or any other protected status in accordance with applicable federal and state laws.